Title
Recommendation to Authorize the Interim City Manager to Execute a Fourth Amendment to the Agreement with the Regents of the University of California (UCSF School of Medicine, Department of Emergency Medicine) for Medical Director Services for the Alameda Fire Department by Extending the Term Through February 28, 2028, in an Amount Not-to-Exceed $216,582 for the Two-Year Extension and a Total Agreement Amount of $382,079. (Fire 10032260/10032270)
Body
To: Honorable Mayor and Members of the City Council
From: Adam W. Politzer, Interim City Manager
EXECUTIVE SUMMARY
Approval of this item will authorize the Interim City Manager to execute a fourth amendment to an existing Agreement with the Regents of the University Of California, on behalf of its UCSF School of Medicine, Department of Emergency Medicine (UCSF) to provide the services of the Medical Director for the Alameda Fire Department (AFD) and ensure the continuity of required oversight of AFD’s controlled substance program, provide clinical education and quality assurance for AFD’s Emergency Medical Technicians (EMT) and Paramedics (EMT-P). The Fire Department is required to have a licensed physician serving as the Medical Director to have the ability to provide paramedic services to the City of Alameda (City).
BACKGROUND
On January 1, 2000, AFD began providing Advanced Life Support (ALS) services to the City’s residents and visitors. As a requirement of Alameda County for ALS service provision, AFD must retain an Emergency Physician to serve as the Medical Director for its ALS program. Since July 2020, UCSF has provided these professional medical director services.
On July 29, 2020, the City entered into an agreement with UCSF to provide Medical Director services through December 31, 2021, in an amount not to exceed $67,818.24.
On January 1, 2022, the City and UCSF executed a First Amendment to extend the Agreement, allowing both parties additional time to negotiate a longer-term arrangement.
Subsequently, on March 1, 2022, the City and UCSF entered into a Second Amendment, extending the agreement term by 24 months and increasing the not-to-exceed amount by $72,064.76, for a revised total of $139,883. This Amendment extended the agreement through February 29, 2024.
On May 1, 2024, the City and UCSF executed a Third Amendment, further extending the agreement by 24 months and increasing the not-to-exceed amount by $174,478, bringing the total agreement value to $382,079. The Third Amendment extended the term through February 28, 2026.
DISCUSSION
The Medical Director serves in several critical capacities within the Alameda Fire Department Emergency Medical Services Division (AFD EMS). The Medical Director allows AFD EMS to meet the Federal, State and County requirements for physician oversight of Emergency Medical Services and the controlled substances (narcotics) program that is a requirement for providing paramedic services.
The Medical Director provides the following critical functions within the AFD EMS:
1. Serves as the subject matter expert in Occupational Safety and Health Administration (OSHA) mandated post-exposure follow-up when firefighters and paramedics have been exposed to infectious diseases in the field during the provision of First Responder services.
2. Assists with development and implementation of policies and procedures that comply with the Federal Controlled Substances Act, Section 812, California Controlled Substance Act and Regulations, Division of Control Amendments of 1984, Registrant Protection Act of 1984, Health and Safety Code Section 11122 and the California Board of Pharmacy.
3. Provides clinical oversight for AFD EMS-related training programs developed and/or provided to EMTs and Paramedics. This ensures that AFD EMS continuing education corresponds with advances in medical knowledge, technologies and modern procedures.
4. Provides medical oversight of general infection control programs, policies pertaining to hazardous situations and exposures in the field.
5. Serves as a clinical instructor for AFD by obtaining the latest findings in emergency medicine and conveying them to the field setting where they can be applied by AFD EMTs and EMT-P.
6. Serves as the lead during clinical call reviews to investigate potential clinical issues resulting from responses by first responders for medical services in the City and throughout Alameda County.
Since UCSF is currently providing State and County mandated services for the Department and its ALS program and based upon the length of the currently assigned physician’s tenure, regional expertise, proven capabilities and relationship, staff recommends the extension of the current Agreement through February 28, 2028.
This report seeks City Council approval of a Fourth Amendment to the Agreement with UCSF. The Amendment does not increase the overall contract compensation amount of $382,079 previously authorized under the Third Amendment. To date, expenditures have not exceeded this amount.
The Fourth Amendment revises the terms of compensation and establishes a new not-to-exceed amount of $216,582 for the extended term, while ensuring the total Agreement remains capped at $382,079. Additionally, this amendment extends the Agreement term by 24 months, through February 28, 2028.
ALTERNATIVES
City Council may:
• Approve the Fourth Amendment as recommended;
• Approve the Fourth Amendment with revisions determined necessary by the City Council; or
• Not approve the Fourth Amendment and direct staff to proceed with another approach, which would have a serious impact on the Fire Departments’ ability to provide paramedic services (Advanced Life Support) to the City of Alameda.
FINANCIAL IMPACT
The City Manager previously approved the original Agreement, the First, Second and Third Amendment as presented below:
|
Contract |
Approval Term Date |
New Authorized Amount |
|
Original Contract |
July 29, 2020 - December 31, 2021 |
$67,818.24 |
|
1st Amendment |
January 1, 2022 - February 28, 2022 |
Term extension only |
|
2nd Amendment |
March 1, 2022 - February 29, 2024 |
$139,883 |
|
3rd Amendment |
March 1, 2024 - February 29, 2026 |
$382,079 |
|
4th Proposed Amendment |
March 1, 2026 - February 29, 2028 |
$216,582 (within total $382,079) |
Approval of the Fourth Amendment does not increase the overall Agreement compensation amount of $382,079 previously authorized under the Third Amendment. To date, expenditures have not exceeded this amount.
The Fourth Amendment revises the terms of compensation and establishes a new not-to-exceed amount of $216,582 for services provided during the extended term, while ensuring the total agreement remains capped at $382,079. Additionally, this amendment extends the agreement term through February 28, 2028.
Funding for the medical director services is included in the Fiscal Year 2026-27 budget. Fiscal Year 2027-28 appropriations will be subject to future City Council approval.
MUNICIPAL CODE/POLICY DOCUMENT CROSS REFERENCE
This action is consistent with the Alameda Municipal Code Section 2-59 (Authorization of Contracts). This action supports the Strategic Priority, “Enhance Community Safety & Services” in the City’s Strategic Plan. This action is subject to the Levine Act.
ENVIRONMENTAL REVIEW
This action does not constitute a “project” as defined in California Environmental Quality Act (CEQA) Guidelines Section 15378 and therefore no further CEQA analysis is required.
CLIMATE IMPACT
There are no identifiable climate impacts or climate action opportunities associated with the subject of this report.
RECOMMENDATION
Authorize the Interim City Manager to execute a Fourth Amendment to the Agreement with the Regents of the University of California, on behalf of its UCSF School of Medicine, Department of Emergency Medicine, to provide Medical Director services for the Alameda Fire Department through February 28, 2028. The amendment establishes a not-to-exceed amount of $216,582 for the two-year extension, while maintaining the total agreement compensation at $382,079.
Respectfully submitted,
Nicholas Luby, Fire Chief
By,
Anne Iturraran, Fire Administrative Service Manager
Financial Impact section reviewed,
Ross McCarthy, Finance Director
Exhibits:
1. Fourth Amendment to the Agreement
2. Original Agreement and Amendments